What is a professional hygiene appointment, exactly?

When my patient is in the chair and I am rendering their mouth squeaky clean, it’s difficult for me to explain what I am doing. It’s also hard for my patient to concentrate because they have pointy instruments in their mouth! So this blog is the answer.

I am going to talk you through a virtual appointment. Take off your coat and settle yourself in the chair. After you have filled me in on how your orthodontic treatment is going, I will get to work. First I carry out a Basic Periodontal Examination (BPE). This involves scoring six areas of your mouth using a probe.

The probe is gently pushed between the side of each tooth and the gum. What I am doing is checking to see how far the probe will go down below the gum line and if you have pockets. These are bad news. They are gaps between the tooth and gum which harbour bacteria. You can find out more about this here.

Essentially, if your oral hygiene is excellent and your life is running smoothly (stress can trigger gum problems), there will be no pockets and your BPE scores will be low, with zero being the ideal. To sum things up, I don’t want to find pockets and you don’t want a score. The BPE is important because it allows me to feed back to you how well (or not) you are looking after your teeth. I will highlight the troublesome areas and explain what you need to do and which tools to use.

Then it’s time for a thorough cleanse! The usual word for this is a scale and polish but it’s so much more than that. It’s more like a highly targeted jet-cleaning of the mouth to remove any bacteria or bits of food or stains! When I scale your teeth I remove all calculus and plaque, both on the visible and invisible surfaces. I am sometimes asked why I carry out two different types of scaling. The answer is simply that this is best for patients.

The majority of the work is done with the ultrasonic scaler which uses ultrasound and water. The benefits of the ultrasonic clean are numerous: it removes calculus quickly and gently, removes plaque and gets into difficult areas and irrigates pockets.

Many of my patients prefer the ultrasonic to hand scaling. However, there are situations where hand scaling is a necessary. Very narrow gaps and tiny crevices where ultrasonic doesn’t reach require hand scaling. Also, with a hand scaler I can make sure that any build up of plaque is removed. Due to its vibrating mechanism, the ultrasonic won’t always pick up build-up but with a manual scaler, I can feel the problem areas and see more easily what is being removed. With an ultrasonic scaler the water washes away any debris so I don’t get the same visual evidence. The final part is the thorough clean using prophy polish.

If you are not a patient of the London Lingual Orthodontic Clinic – only our patients are eligible for hygiene appointments here – I hope that this blog has fired up some questions in your mind. Does your hygienist tell you what your BPE is? Do you usually experience both ultrasonic and manual cleaning? Does your appointment take half an hour at least? These are the kinds of things you should be looking for if you are to experience an optimum hygiene appointment.